Have you ever tried to survive for one day without water and sanitation?

Most of us in the developed world rarely have to face such a situation; and if so, we become very quickly concerned, because we expect water and sanitation to always be there. However, for 1.5 billion people in the developing world, the answer to such a question is yes, day after day.

“If you’ve ever been without water for 24 hours, you know what an impact it has on your life,” said Peter Lochery, Senior Advisor, Water and Sanitation Sector, Cooperative for Assistance and Relief Everywhere, Inc. (CARE).

The link between water and sanitation and quality of life is palpable. Access to safe water and sanitation increases school attendance, improves health, and gives people more time and energy to generate an income. “Quantity and quality of water gives you multiple benefits, and by the time you start adding the impact of sanitation and hygiene, those benefits double,” said Lochery.

Increasingly, domestic water supplies in developing countries are threatened by pollution from industrial waste, untreated sewage, and chemicals in agricultural runoff. About 2.6 billion people do not have adequate sanitation; this is more than twice the amount of those who lack access to an improved water supply. And unless action is significantly accelerated to satisfy the dire need for clean water and sanitation, it is estimated that 2.7 billion people in the developing world will experience severe water scarcity by 2025.

Impoverished people often cite access to safe water as a priority in their visions for the future. According to Susan Davis, National Water Strategist/Senior Director of Development, CARE, a quarter of the world’s population does not having access to safe water, and that number increases when one considers frequent breakdowns in water systems. “Even when we think communities have access, the water is sporadic despite an available tap or hand pump. A lot of times, the people are waiting for water and it doesn’t come.”

Though the wait for water to come in the developing world seems endless, the humanitarian drive to get clean water and sanitation to people in need is strong.

“There’s a solution, it’s been around for a long time, it’s relatively inexpensive, and it’s not technology driven. The answer is found in educating people and confronting the man-made barriers to water access,” said Davis. “CARE knows how to do that.”

According to Lochery, a water expert with over 35 years of experience in the sector, keeping people in the community at the center of a water program is the way to attain and sustain proper access.

“If you want someone to be part of a team then you have to keep them informed. Just imagine your team includes people from a community, but nobody speaks to them because the whole focus is on installing this piece of the technology – a tap or hand pump,” he said. “Yes, technology is important, but it shouldn’t be at the center of the program or project. People should be at the center because ultimately they are going to make the decisions, and decide whether something is sustainable or not.”

CARE’S IMPACT ON THE WATER AND SANITATION SECTOR

CARE believes that educating others on the importance of sustainable resource management is the key to long-lasting water programs. Strategically, the goal of CARE’s water programming is to “enhance the livelihood security of poor rural and urban communities through equitable access, efficient use and sustainable management of limited and dwindling water resources.”

After more than half a century in the sector, CARE has demonstrated how to enhance livelihoods with bona fide results. To date, the not-for-profit organization has helped deliver water services to over 20 million people in more than 40 countries around the world. Yet, despite great advances, an enormous underserved population remains.

“It’s not a question of availability worldwide. There is enough water on the planet available to sustain human life. But if people aren’t getting water then obviously there is something more to it,” said Melissa Diallo, Water Programming Intern, CARE. “So in that sense, there is a problem politically.”

CARE looks for ways to get water to everyone by working to promote changes in government policies and creating alliances. The organization collaborates directly with other NGOs, with members of rural communities, and urban neighborhoods. Most recent alliances with CARE include Proctor & Gamble, the Bill & Melinda Gates Foundation, and the William J. Clinton Foundation. Such partnerships provide assistance, more funding and training needed to construct and manage low-cost water and sanitation systems. Diallo points out that CARE’s water team stresses integrated water resource management projects in their work.

“People think water and sanitation, they think pump and latrine. We don’t just go in and install a pump, and stick a big CARE logo on it and call it a day,” she said. “You need to have latrines along with capacity building so people know the different ways to manage water and sanitation in that community. It’s on-going.” To date, the organization’s work includes approximately 150 projects operating with water or water-related activities worldwide. CARE works in many countries in Latin America, the Caribbean, Sub-Saharan Africa and Asia.

The expanded focus of the water and sanitation sector in Latin America and the Caribbean ranges from emergency relief to long-term planning for infrastructure development. For example, CARE in Ecuador has contributed to the implementation of 26 percent of all water systems completed in rural areas in the country.

“If you look at obstacles in water programming, it often comes down to that initial capital piece. Instead of a grant-based program where you have to wait for CARE to raise some money and show up, we’re helping communities who have some income do a loan-based program,” said Davis. “It’s sort of a revolving grant.” Such a grant over time ensures people are self-reliant and not dependent on CARE.

CARE’s water and sanitation program emphasizes a holistic approach by addressing the specific needs of a region both geographically and culturally. Although water is not as scarce in some regions, in comparison to others, the people who usually suffer most are those living in the rural areas or urban slums that have sprouted in cities. The result is communities can lack sewers, appropriate waste treatment and disposal facilities. When wastewater is discharged directly into bodies of water that serve as drinking water for other communities, the impact on the environment and the health of the population is devastating.

In Sub-Saharan countries like Kenya, despite years of development assistance, an imbalance continues to persist between rural and urban areas in the rate of access to water and sanitation. In the past 30 years, the population of Kenya has tripled, while renewable freshwater availability has decreased by more than 60 percent. Rapid population growth coupled with weak infrastructure creates challenges for the water sector in Kenya. Particularly in rural areas, communities are most vulnerable to changes in water availability, and are least able to cope with the variations.

“Rural areas are typically underserved in any developing country,” said Davis. “Extremely poor people in rural areas don’t have a voice and nobody really pays attention to them.”

To address the problem, CARE has instituted a number of programs including one in Kenyan schools that helps provide water access to the students. The project involves substantial collaboration with international and corporate partners, such as Coca-Cola, The Millennium Water Alliance, The Center for Global Safe Water, and the Centers for Disease Control and Prevention (CDC).

The original pilot project with the CDC was so successful that it inspired the Coca-Cola Africa Foundation to support an expansion to 45 additional schools in the country. Soon after, the World Health Organization added funding for 10 additional schools in its Healthy Environments for Children Alliance.

An evaluation later conducted by the CDC in collaboration with CARE in Kenya and Emory University’s Rollins School of Public Health documented a 29 percent decrease in student absenteeism. Aside from all the positive results, Dr. Robert Quick of the Food-borne and Diarrheal Diseases Branch at the CDC, said there is an even more to be learned from working on projects such as the one in Kenya. “The best part is visiting the schools and witnessing first hand the project’s impact on the students,” he said. “The CDC has had a close, productive relationship with CARE Kenya for the past seven years, and the local CARE staff are among the most dedicated people I have ever worked with.”

CARE and CDC’s collaboration in Kenya also includes a project that focuses on water treatment and storage through Safe Water Systems (SWS) in households, health clinics and schools. The SWS approach uses chlorine-based purification and safe storage containers to avoid contamination. CARE was the first organization to promote SWS in collaboration with the CDC, and the system is sorely needed in places like Kenya to avoid risk from waterborne diseases. Pollution of drinking water sources over time in the country has led to high incidences of malaria, typhoid, cholera and other diarrheal diseases. And while clean water can come from clean community sources initially, it could become contaminated during transport or storage in the home and may require further treatment, Dr. Quick warned.

Equally prepared to be reactive in times of emergency, CARE played a significant role in providing expert assistance in the aftermath of the 2004 Indian Ocean tsunami. Known for its disaster relief work, CARE was able to quickly provide clean drinking water and technical expertise to rehabilitate destroyed sources. “Emergencies are often an opportunity to improve the infrastructure and we can at least lessen the impact of future natural disasters,” said Davis.

WOMEN & WATER

When it comes to water, poor women are disproportionately excluded from decisions regarding its allocation and management. At the community level, the burden and drudgery of collecting water is mostly borne by women and girls. Often times, they must carry not only a baby on their backs, but every liter of water that their families use for drinking, cooking, bathing and subsistence horticulture. The back-breaking labor can take up to six hours a day. To avoid such a situation, adequate water and sanitation facilities are fundamental to the dignity of women. And because girls often drop out of school when they reach puberty if there are no proper, private latrines, improved sanitation can change the whole course of a child's life.

In some communities where there are no indoor toilets, the burden women face can be agonizing. “In some cultures, the women aren’t allowed to be outside. So they have to wait until dark to go relieve themselves. Then they still have to go somewhere they won’t be seen,” said Davis. “To have somewhere private and safe where women can go in the middle of the day, that’s a huge thing.”

CARE strives to overcome such obstacles by striking a more balanced division between women and men in terms of access to information, physical work, contributions in time and cash, decision-making, and access to and control of resources and benefits. On a given water committee or in discussions on water and sanitation, CARE provides women with equal access to information. “Many women stand up and say this changed my life and we’re never going to let this end, because we’re not going back to what life was like before,” Davis said.

Jeneba Dauda, a young mother from Sierra Leone, echoed a similar sentiment.

“I like attending the health meetings because each time I go, I get a new idea.”

ADVOCACY FOR RELIABLE WATER SUPPLIES

“What CARE is really trying to do is go beyond service delivery and move more toward changing the way governments do business when it comes to water and sanitation,” said Davis. “In a lot of projects that we’re operating, we are really trying to look at how do we engage the government at the local level, the municipal level, or the state level. There’s lots of different ways to engage the government.”

In April 2006, CARE’s water team leader Peter Lochery participated in a United States Congressional hearing as part of a campaign to raise the profile of water and sanitation. The main focus of the campaign was to make water and sanitation a more important element of US foreign assistance, and help the US government to play a stronger leadership role in the effort to fight the global water crisis. [Peter’s Testimonial Hyperlink Here] Moreover, CARE advocates at high levels of government for communities to receive information and training on their legal right to protected water sources, how they can secure drinking water, and how they can work with their municipalities to protect this precious resource.

WATER IS LIFE

The issue of the availability of water and sanitation is just as important as any global health pandemic today. CARE is working to expand access to safe water and help families manage the resource for not only the current population, but for future generations, as well. Implementing water and sanitation programs in developing countries that are plagued by poverty presents a unique opportunity to help secure a solid foundation of long-term livelihood and security. Some say that is what makes water so unique.

“In the case of water there is a cure, there is an answer. We don’t need new technology. We just need investment,” said Davis.

*For more information about CARE’s work and how you can help, please visit www.care.org